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Helping Patients with Tobacco Cessation

Sandra M. Swain, MD, FACP

03 Oct 2012 9:30 AM

I am pleased to report that ASCO recently launched Tobacco Cessation Guides for providers and patients to explain the importance of tobacco cessation for patients undergoing cancer treatment, to identify ways to help patients quit, and to help providers navigate reimbursement channels for tobacco cessation services.

“It’s about time!” you might say—for those of us in the oncology community to fully confront this serious health issue that many of our patients struggle with at an extremely vulnerable time in their lives.

It’s about time we put major efforts into helping our patients with a powerful addiction that has evidence-based negative consequences. For our patients undergoing cancer treatment, these consequences include shorter survival spans, higher complication rates from surgery, higher treatment-related toxicity from chemotherapy and radiotherapy, and increased risk of cancer recurrence.

It’s about time oncology providers have the necessary tools to help them incorporate tobacco dependence treatment into their practices.

And it’s about time we recognize and confront the complexities inherent in nicotine addiction, an addiction that takes a disproportionate toll on lower-income populations in the U.S., and an addiction that is growing at alarming rates in developing countries, according to the largest-ever tobacco study, the Global Adult Tobacco Survey (GATS), published in Lancet.

Tobacco use by patients undergoing cancer treatment may seem—on the surface—to be an easy problem to confront. Evidence ties tobacco use to cancer development and impedes cancer treatments, so...the solution should be easy—stop using tobacco. But of course nothing is that easy, and those of us in the oncology field know that problem is far more complex than handing out simple directives. Tobacco is a profound addiction, and the ongoing challenges of a cancer diagnosis and painful treatment create a difficult road for even the most motivated patients. This is perhaps why some physicians may be hesitant to address tobacco use with patients.

Fortunately, ASCO’s Tobacco Cessation Subcommittee has recognized the complexity and the severity of the problem and has been working diligently to provide practical solutions for both oncology professionals and patients outlined in two new publications:

  • “The Tobacco Cessation Guide for Providers” includes information on talking to patients about tobacco use, including sample dialogues; motivating patients to stop; treating nicotine dependence; and incorporating cessation treatments into a practice.
  • The guide “Stopping Tobacco Use After a Cancer Diagnosis” is a resource booklet for patients and families.

We may be frustrated in our attempts to halt the global spread of tobacco use and addiction, but we can certainly take steps to curb the use of tobacco by our patients undergoing treatment. Kudos to ASCO’s Tobacco Cessation Subcommittee—notably Subcommittee Chair Carolyn Dresler, MD, MPA; lead author on the providers’ guide Michael Cummings, PhD; and the entire Editorial Board—for creating these very useful tools for oncology teams and patients.

Both guides are available online for members to download, or to purchase in the ASCO University Bookstore; they are also accessible via the ASCO iLibrary app for iPad.


Number of Comments: 1
Suresh Ramalingam

Monday, October 08, 2012 7:36 PM

Thank you, ASCO!

As a thoracic oncologist, I was pleased to see ASCO's new initiative to help patients and providers with tobacco cessation. I reviewed the guides for physicians in length and find this to be a comprehensive source of information on this important topic. The questionnaires provided to assess smoking use are very concise and complete. These could be easily incorporated into medical records and pre-visit documentation.  The summary of resources available for patients and the table with discussion of pharmacological interventions are outstanding. Dr. Dressler, Cummings and the others that contributed to this important effort deserve our sincere gratitude. I highly recommend this to my fellow colleagues and patients.

Suresh Ramalingam
Emory University, Atlanta, GA. 

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Sandra M. Swain, MD, FACP